Is artesunate effective in treating COVID-19?

The novel coronavirus pneumonia (COVID-19) epidemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become a serious threat to public health. As of May 2022, there have been approximately 500 million confirmed cases worldwide and more than 6 million deaths. (artesunate) is one of the derivatives of artemisinin. Because of its safety and high bioavailability, it is clinically used for the rescue treatment of critical malaria. In addition, ART also has anti-viral, anti-inflammatory and anti-tumor effects. So, is artesunate effective in treating COVID-19?

The effectiveness of artesunate in treating COVID-19

Using a prospective research method, 43 patients diagnosed with COVID-19 admitted to Nanning Fourth People's Hospital from January 22 to February 15, 2020 were selected as the research subjects. The patients were divided into the conventional treatment group (25 cases) and the artesunate combined treatment group (18 cases) according to the order of admission odd and even numbers [1].

The conventional treatment group was given lopinavir/ritonavir 500 mg + α-interferon 500 × 10 4 U aerosol inhalation as recommended by the guidelines, twice a day; the artesunate combined treatment group was given intravenous artesunate 60 mg, twice a day, on the basis of conventional treatment, and the treatment course for both groups was 10 days. During the treatment period, throat swabs were tested for novel coronavirus (2019-nCoV) nucleic acid every 2 days, and routine blood tests, liver and kidney function, coagulation function, and cardiac enzymes were reviewed. Chest CT was performed every 3 days at the beginning of treatment, and rechecked every 5 days after the condition improved. The changes in blood routine and biochemical indicators of the two groups of patients were compared, as well as the time when symptoms improved significantly, the time when throat swabs became negative for viral nucleic acid, the time when lung lesions were absorbed, adverse drug reactions and days of hospitalization were compared to evaluate the efficacy.

Results: There were no statistically significant differences in general information such as gender, age, weight, and pre-treatment blood routine and biochemical indicators between the two groups of patients. After treatment, the symptoms improved significantly in the artesunate combined treatment group (d: 3.33±1.91 vs. 4.84±2.19), the time when the 2019-nCoV nucleic acid test turned negative (d: 4.72±2.16 vs. 6.68±3.76), and the time when lung disease began to be absorbed (d: 5.39±2 .36 vs. 7.48±3.78), the time for lesion absorption >70% (d: 14.11±4.16 vs. 17.04±4.42) and the hospitalization time (d: 16.56±3.71 vs. 18.04±3.97) were all significantly shorter than those in the conventional treatment group, and the differences were statistically significant (all P<0.05); however, there was no statistically significant difference in the incidence of adverse drug reactions between the two groups (72.2% vs. 80.0%, P>0.05).

Conclusion

Artesunate can shorten the treatment time of patients with new coronavirus pneumonia, improve prognosis and eliminate pathogens, has few adverse reactions, and has good application prospects.

References

[1] Lin Yanrong, Wu Fengyao, Xie Zhouhua, Song Xiaoling, Zhu Qingdong, Wei Jing, Tan Shiji, Liang Lianshao, Gong Beibei. Clinical study of artesunate in the treatment of new coronavirus pneumonia [J]. Chinese Critical Care Medicine, 2020, 32(04): 417-420.

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